NOUAKCHOTT, MAURITANIA
— Big has long been considered beautiful in Mauritania. But now, a generation of women are abandoning an ancient practice to fatten up – and some are even redefining beauty to put their health first.

It's not a lifetime spent scoffing junk food and slurping fizzy drinks that's to blame for obesity here; rather, a tradition as old as the desert: gavage.

On the tree-lined boulevards of Paris, the French word describes the process of fattening up geese to produce foie gras. On the sand-blanketed streets of Mauritania's capital, Nouakchott, it describes the process of forcibly funneling sweetened milk and millet porridge down the throats of young girls. In this vast nomadic nation, thin women are an admission of poverty. Voluptuous wives and daughters, by contrast, are displays of a man's wealth, and that's where force-feeding comes in.

After campaigns at the national and community level, the brutal practice is on the way out. The latest government survey, in 2001, estimated that about 10 percent of women ages 15-19 were force-fed as young girls, down from 35 percent among 45 to 54-year-olds. But that older generation of women is now battling a variety of illnesses as well as child-bearing complications, doctors and midwives say.

"Even getting out of bed is difficult for some of them, never mind working," says Mariame Baba Sy, the head of a government commission on women's issues.

While it's clear that the practice of force-feeding women is on the decline, the government doesn't keep statistics on obesity, or track if the decline in gavage is translating into a slimmer, healthier population. Indeed, some young girls may just be turning to a less painful way to meet the Mauritanian beauty ideal.

"The real gavage is on the point of becoming extinct. But there's a new method," says Ms. Baba Sy. "They take pills, some of them ones you usually give to an animal."

Market vendors offer girls boxes of large pink tablets from Pakistan, marked as unfit for human consumption, and packets of Chinese pills intended to treat rheumatism. Vendors say they are scrambling to keep them in stock for the growing number of young girls, usually the poorer and less educated, wanting to pile on the pounds.

"Have you seen this?" says young Fatou, gesturing at a protruding collarbone. "Look how much it's sticking out. I need to be plumper." And with that, she tucks a packet of pills into her shopping bag, alongside a new dress and some makeup.

Some women, though, are rejecting the beauty standard and losing weight. Swing by the sports stadium in Nouakchott as dusk falls and you'll see scores of chubby ladies determinedly pattering around the track, their sneakers poking out beneath their traditional mephala robes.

Although some women are starting to abandon the old ideal of beauty for a healthier and more streamlined one, men still cling to the corpulent canon. So while M'barka Mint M'haimid has embraced exercise, there is one thing she hates about it -- the guys that stop their cars and offer her a lift.

"They just don't understand that I want to lose weight," explains the middle-aged woman, who says her favorite place in the house is now the bathroom scale.

After being force-fed as a child, M'haimid now won't touch milk or millet, staples that were pumped into her every two hours, even when she kept vomiting. While she talks proudly about the 22 lbs. she has lost in the past month, she knows that at 264 lbs., she cannot rest.

"My husband tells me not to tire myself out with this weight loss. These Mauritanian men, they still love fat women. But my health is more important," she says.

Mariam Aicha, a former mayor of Nouakchott, recalls a doctor addressing delegates at a recent conference on health. "He said that, from his professional point of view, it was the thinner the better, but then admitted that as a man, he liked something to hold on to," she says.